Development of a Computerised Adaptive Testing and Equalisation Approaches to Assess Sleep and Quality of Life in Chronic Pain.

Background: Computerised adaptive testing (CAT) and equalisation are statistical approaches that mitigate questionnaire response burden by selecting individually tailored items according to previous response patterns; they facilitate comparing results across distinct instruments by providing conversion functions between their scores, respectively. However, they have seldom been specifically applied to the general chronic pain population. This study aimed at developing CAT and equalisation approaches for widely used sleep quality and quality of life (QoL) assessment instruments.

Insula Deep Brain Stimulation for Neuropathic Pain: A Cross-Over, Randomized, Sham-Controlled Trial.

Objective: Despite neuropathic pain affecting a significant portion of the population, many people still experience refractory conditions. Here, we evaluated the efficacy and safety of posterior-superior insula deep brain stimulation for pharmaco-resistant neuropathic pain.

Materials And Methods: This was a phase 2 randomized, double-blind, sham-controlled, cross-over trial.

Socioeconomic and lifestyle factors associated with chronic musculoskeletal disorders in Brazil: a network analysis of a population-based study involving 87,648 Brazilian adults.

Background: Musculoskeletal disorders (MSKDs) are the leading cause of disability worldwide. The associations between socioeconomic and lifestyle factors and MSKDs have been widely studied in Europe and North America. However, little data are available about their relationship in Latin America.

De novo post-COVID-19 chronic pain: a piece of information about risk factor and clinical features.

Objective: SARS-CoV-2 infection has been linked with chronic pain, leading to disability and affecting quality of life. Single nucleotide polymorphisms in the Mu-opioid receptor gene, which influence pain intensity, perception, and analgesic response, may contribute to chronic pain development. We compared patients with de novo post-COVID-19 pain with individuals with chronic pain due to knee osteoarthritis (OA) and investigated whether opioid receptor Mu 1 () polymorphisms (rs1799971; rs1799972) were associated with de novo pain.

Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial.

Background: Despite affecting 2-4% of the population worldwide, fibromyalgia often remains refractory to treatment. Here we report the first international randomised double-blind, sham-controlled trial developed to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an add-on therapy for fibromyalgia.

Methods: Women aged ≥18 yr with fibromyalgia refractory to best available treatment were enrolled in Brazil, France, and Japan, and randomised to 10 Hz motor cortex (M1) rTMS, 3000 pulses day, or sham stimulation.

Intraoperative recordings from the posterior superior insula in awake humans with peripheral neuropathic pain.

Background And Objectives: The activity profile of the posterior insula in neuropathic pain (NeP) remains largely unexplored. To address this and examine its modulation by somatosensory stimulation, we recorded local field potentials (LFP) in awake patients with NeP undergoing deep brain stimulation (DBS) electrode implantation to the posterior-superior insula (PSI) for analgesic purposes.

Materials And Methods: Six patients (one woman; 32-45 years), experiencing refractory peripheral NeP and having previously responded to non-invasive stimulation of the PSI underwent stereotactic implantation of DBS electrodes to the PSI as part of a phase II clinical trial.

Evidence-Based Umbrella Review of Non-Invasive Neuromodulation in Chronic Neuropathic Pain.

Background And Objective: Non-invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision-making.

METHA-NeP: effectiveness and safety of methadone for neuropathic pain: a controlled randomized trial.

In this randomized, double-blind, parallel placebo-controlled clinical trial, we evaluated the efficacy of methadone as an add-on therapy for people with chronic neuropathic pain (NP). Eighty-six patients were randomly assigned to receive methadone or placebo for 8 weeks. The primary outcome was the proportion of participants achieving at least 30% pain relief from baseline using a 100-mm pain Visual Analogue Scale.

Posterior insula repetitive transcranial magnetic stimulation for chronic pain in patients with Parkinson disease - pain type matters: A double-blinded randomized sham-controlled trial.

Objectives: Altered somatosensory processing in the posterior insula may play a role in chronic pain development and contribute to Parkinson disease (PD)-related pain. Posterior-superior insula (PSI) repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to have analgesic effects among patients with some chronic pain conditions. This study aimed at assessing the efficacy of PSI-rTMS for treating PD-related pain.

Assessment of Human Fetuses Undergoing Acute Pain: Validation of the Fetal-7 Scale.

Improvements in fetal ultrasound have allowed for the diagnosis and treatment of fetal diseases in the uterus, often through surgery. However, little attention has been drawn to the assessment of fetal pain. To address this gap, a fetal pain scoring system, known as the Fetal-7 scale, was developed.

Long-Term Environmental Methylmercury Exposure Is Associated with Peripheral Neuropathy and Cognitive Impairment among an Amazon Indigenous Population.

Widespread contamination of the Amazon basin with mercury has been reported to occur since at least the mid-80s due to heavy gold mining activity. Although initial studies have indicated that this may lead to deleterious neurological consequences to the indigenous populations living in the region, further research is needed to better characterize the neurological burden of such long-term exposure. With this aim, a cross-sectional exploratory study has been conducted with the Yanomami indigenous population residing in a northern Amazon region.

Motor corticospinal excitability abnormalities differ between distinct chronic low back pain syndromes.

Objectives: It is not known whether cortical plastic changes reported in low-back pain (LBP) are present in all etiologies of LBP. Here we report on the assessment of patients with three LBP conditions: non-specific-LBP (ns-LBP), failed back surgery syndrome (FBSS), and sciatica (Sc).

Methods: Patients underwent a standardized assessment of clinical pain, conditioned pain modulation (CPM), and measures of motor evoked potential (MEPs)-based motor corticospinal excitability (CE) by transcranial magnetic stimulation, including short interval intracortical inhibition (SICI), and intracortical facilitation (ICF).

Pain paths among post-COVID-19 condition subjects: A prospective cross-sectional study with in-person evaluation.

Background: New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features.

It is time anti-CGRP monoclonal antibodies be considered first-line prophylaxis for migraine.

The result of more than thirty years of research, anti-CGRP monoclonal antibodies are currently the state of the art for migraine preventive therapy. Their efficacy and safety, supported by an already large and growing body of evidence, are added by many other advantages: an early onset of action, favorable posology, negligible pharmacological interaction, and a broad-reaching efficacy in many challenging clinical contexts. When compared to standard prophylactics, these novel medications seem at least as efficacious, clearly more tolerable and, consequently, with a superior adherence profile.

Prevalence and characteristics of new-onset pain in COVID-19 survivours, a controlled study.

Background: We assessed whether COVID-19 is associated with de novo pain and de novo chronic pain (CP).

Methods: This controlled cross-sectional study was based on phone interviews of patients discharged from hospital after COVID-19 compared to the control group composed of individuals hospitalized during the same period due to non-COVID-19 causes. Patients were classified as having previous CP based on the ICD-11/IASP criteria, de novo pain (i.

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital.

Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized.

Gerstmann's syndrome and unilateral optic ataxia in the emergency department.

A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.

Popular stroke knowledge in Brazil: A multicenter survey during "World Stroke Day".

Context And Objective: Cerebrovascular disease is one of the most important causes of death and disability worldwide. The patient's inability to identify the warning signs of stroke substantially delays the search for emergency services, which is related directly to a worse outcome. Thus, during the 2011 Stroke Campaign in Brazil, a survey was conducted to identify the lay population's knowledge with regard to the recognition, treatment, and prevention of stroke.

Patients with cirrhosis in the ED: early predictors of infection and mortality.

Background: Patients with cirrhosis have high risk of bacterial infections and cirrhosis decompensation, resulting in admission to emergency department (ED). However, there are no criteria developed in the ED to identify patients with cirrhosis with bacterial infection and with high mortality risk.

Study Objective: The objective of the study is to identify variables from ED arrival associated with bacterial infections and inhospital mortality.